Since the 1960s, The Gambia and Senegal have experienced an impressive improvement in the survival of infants and young children. Despite economic difficulties, droughts and a relatively slow increase in education and living standards, especially in the rural areas, child survival has improved steadily until today. The comparison of the experience of The Gambia and Senega, countries with similar disease environments, provides an opportunity to isolate some major factors contributing to the childhood mortality decline.
Detailed analysis of the changing age patterns and causes of death in two rural study sites (Niakhar in Senegal and Farafenni in The Gambia) are presented. These sites provide demographic and health information for a rural population followed in each case for over twenty years. The role of immunization and the contribution of the health care system are given special attention.
A broader analysis using national survey and census data complements the study of the rural population. Special attention is given to urban mortality and to differentials in child survival by place of residence and social class within the urban areas.
The paper concludes that some basic, low-cost health interventions have contributed substantially to the recorded mortality improvements. The organization and coverage of the health services in the two countries are very different but some elements appear to be common to both. These features of the health services are discussed and recommendations are drawn on the future needs for health care provision in both rural and urban areas in West Africa.
Learning Objectives: Understanding of the complex factors contributing to mortality decline in developing countries
Keywords: Child Health, Mortality
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.